Is antibiotic necessary prior to dental work after joint replacement?

Is antibiotic necessary prior to dental work after joint replacement?
Is antibiotic necessary prior to dental work after joint replacement?

 

The use of an antibiotic pill prior to dental work has been thought to lower this risk. In 2013, The American Academy of Orthopaedic Surgeons and The American Dental Association worked together to create guidelines for this situation. The work group reviewed the available published data to try and synthesize recommendations for patients and practitioners. Unfortunately, there is not a large amount of quality data.

The work group was unable to recommend for or against the use of topical oral anti-microbials in patients with prosthetic joint implants or other orthopaedic implants undergoing dental procedures. The work group recommended that patients with prosthetic joint implants or other orthopaedic implants maintain appropriate oral hygiene.

Many factors should be considered when you are making this decision, such as the type of procedure being performed, the presence or absence of an active infection in the mouth, and your tolerance of antibiotics.

With the lack of a definitive answer on this question, I strongly recommend the routine use of antibiotics prior to any dental work for all my patients.

1. Watters, W III, Rethman, MP, Hanson, NB, et al: AAOS-ADA Clinical Practice Guideline Summary: Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. Journal of the American Academy of Orthopedic Surgeons. March 2013; 21:180-189.; doi:10.5435/JAAOS-21-03-180